# BILLY C CRISWELL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Criswell Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730435967
- **Authorized official:** DR. BYRL C CRISWELL DDS (PRESIDENT)
- **Authorized official phone:** (479) 474-2828

## Contact information

- **Practice address:** 2411 FAYETTEVILLE RD, STE. C, VAN BUREN, AR 72956-6520
- **Practice address phone:** (479) 474-2828
- **Practice address fax:** (479) 262-6884
- **Mailing address:** 2411 FAYETTEVILLE RD, STE. C, VAN BUREN, AR 72956-6520
- **Mailing address phone:** (479) 474-2828
- **Mailing address fax:** (479) 262-6884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 07/25/2012
- **Last updated:** 07/25/2012